Provider Demographics
NPI:1033944996
Name:AALUND-NELSON, KENRIC JAMES
Entity type:Individual
Prefix:
First Name:KENRIC
Middle Name:JAMES
Last Name:AALUND-NELSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 WOBURN ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-3865
Mailing Address - Country:US
Mailing Address - Phone:360-715-5321
Mailing Address - Fax:
Practice Address - Street 1:2900 WOBURN ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-3865
Practice Address - Country:US
Practice Address - Phone:360-715-5321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61563548183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist